Provider Demographics
NPI:1851695241
Name:JOSE A. DE LEON Y ASOCIADOS, INC.
Entity Type:Organization
Organization Name:JOSE A. DE LEON Y ASOCIADOS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSICOLOGO CLINICO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-207-8547
Mailing Address - Street 1:PO BOX 715
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0715
Mailing Address - Country:US
Mailing Address - Phone:787-202-8547
Mailing Address - Fax:
Practice Address - Street 1:11 CALLE FLOR GERENA N
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4288
Practice Address - Country:US
Practice Address - Phone:787-202-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1311261Q00000X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health